The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). The chancre (sore) is usually firm, round, small, and painless. It appears at the spot syphilis entered the body. The sore lasts 1 to 3 weeks, and it heals without treatment. If adequate treatment is not administered, the infection progresses to the secondary stage.

Skin rash and mucous membrane lesions characterize the secondary stage. This stage typically starts with the development of a rash on one or more areas of the body. The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands or bottoms of the feet. However, rashes with a different appearance may occur on other parts of the body, sometimes resembling rashes caused by other diseases. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will resolve without treatment, but without treatment, the infection will progress to the latent and late stages of the disease.

The latent (hidden) stage of syphilis begins when secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. In the late stages of syphilis, it may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This internal damage may show up many years later. Signs and symptoms of the late stage of syphilis include coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough tom cause death.

Syphilis tests require a blood sample, however some may require an examination (i.e., the Darkfield exam: a gentle abrasion of the chancre).

If you or someone you know has any of these symptoms, visit our "Get Tested" page for locations and times for testing